HomeMy WebLinkAbout5201 WHITE LN SB989 APP 11.8.14UNDERGROUND STORAGE TANKS
APPLICATION
FIRE
TO PERFORM ELD/LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
(please note that these are separate
individual tests and will be charged -per
separate type test accordingly.)
PERMrT # lq-zti -
2,
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
Qlot k-k STIREJE-7
Bakerstield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING DA
❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION =
FACILITY
ADDRESS
OWNER NAME
OPERATOR NAME
# OF TANKS TO BE TESTED:
TANK #
SITE INFORMATION
- 1-1 —J NAME & PHONE # OF CONTACT PERSON
PERMIT TO OPERATE #
IS PIPING GOING TO BE TESTED?
VOLUME
❑ YES ❑ NO
CONTENTS
FD2095 (Rev 03/08)